DR Congo: Cholera and Measles Outbreaks - Jan 2013Ongoing
While the last major cholera outbreak in DR Congo's western provinces was in 2011, cholera is endemic in the eastern provinces, which experienced a resurgence of cases starting in July 2012. Over the course of 2013, ongoing violence and displacement in North and South Kivu, Katanga and Orientale provinces limited access to health care and life-saving vaccination services. Between January and September, more than 21,000 cases of cholera and 376 deaths were recorded with 99% of these cases in the eastern provinces. During the same time frame, more than 74,299 cases of measles and 1,160 deaths had been reported. (WHO, 31 Oct 2013)
In 2013, Katanga was the most-affected province with 13,726 cholera cases and 348 deaths, compared to 6,930 cases and 223 deaths in 2012 (OCHA, 15 Jan 2014). On 7 Dec 2013, the governor of Sud-Kivu officialy declared a cholera epidemic outbreak. More than 6,200 cases had been reported since the beginning of the year. (OCHA, 11 Dec 2013) Country-wide, a total of 26,440 cases of cholera were reported in 2013 (UNICEF, 28 Jul 2014).
Between 1 Jan and 1 Dec 2013, 86,264 measles cases and 1,372 deaths were recorded (WHO, 20 Dec 2013).
By the end of July 2014, 10,551 cholera cases had been reported - almost half the number of cases reported during the same time in 2013 (19,032) (UNICEF, 28 Jul 2014). By October, the total number of cholera cases in 2014 stood at just over 14,000, compared to just over 21,000 in 2013 (UNICEF, 20 Oct 2014). By then end of 2014, a total of 19,305 cases had been recorded (UNICEF, 29 Jan 2015).
Since the beginning of the year, 19,705 cases have been reported in DRC. As of 29 November, the following provinces had reported cases: South Kivu (4,906), ex-Katanga (4,565), Maniema (3,971), North Kivu (3,294) and ex-Oriental (2,969). A high number of cases are still reported in the province of South Kivu where the situation is particularly worrying because of the presence of camps hosting refugees from Burundi. Furthermore, there are concerns that the epidemic in Maniema could spread to other provinces of the country as observed during the 2011 cholera epidemic when areas of Kinshasa were also affected. (WHO,15 Dec 2015)
The protracted outbreak of cholera in [DRC] is still going on unabated ... The situation has continued to worsen with numerous pockets of outbreaks occurring along the Congo River...Since the beginning of the year up to 15 April 2017, a total of 9,160 cases including 315 deaths (case fatality rate of 3.4%) have been reported. Meanwhile in 2016, a total of 29,352 cases, including 817 deaths (case fatality rate of 2.8%) were notified nationwide. With these, the cumulative number of cases and deaths reported since onset of the outbreak is 38,511 cases including 1,419 deaths (case fatality rate of 3.68%). In 2017, the provinces of Tanganyika, South Kivu, Ecuador, Maindombe, Central Kongo, and Tshopo have been the most affected. (WHO, 25 Apr 2017)
In spite of the observed reduction during the reporting week, the cholera outbreak in the Democratic Republic of the Congo remains a concern, with a high weekly incidence and new areas being affected. The cholera epidemic is active in eleven provinces and 66 health zones. The outbreak appears to be following three major river and lake routes, suggesting that these water bodies play an important role in transmission. Towards the east of the country, the affected areas are along Lake Tanganyika and Lake Kivu and the disease appears to be moving towards Lake Albert in the north-east. In the central region, the disease is affecting areas along the internal lakes and along the Congo River, up to Kindu and Maniema. In the western central area, the disease is affecting areas along the Kasai River. (WHO, 23 Oct 2017)
Between W1 and W48, 50,579 suspected cholera cases including 1,083 deaths (Case-fatality ratio of 2.1%) are reported from 23 provinces and 225 health zones. To be noted that while this bulletin was prepared, the completeness rate of the database shared was not of 100%. However, the overall decrease of the reported cholera incidence is clear as the incidence reduces in several provinces (notably North Kivu, South Kivu, Kongo Central, Sankuru, Tanganyika, and Ituri). The epidemic is still expanding to new areas in the Great Kasai, despite an overall reduction in the cumulative incidence. (UNICEF, 15 Dec 2017)
The trend of the outbreak continues to improve nationwide. During week 2 of 2018, a total of 763 suspected cases and 14 deaths (CFR: 1.8%) were reported, compared to 1 022 suspected cases and 19 deaths (CFR: 1.9%) during week 1 of 2018. Most of the cases are reported from during this week are reported from Kinshasa (189 cases), North Kivu (272) and South Kivu (117). From 4-7 January 2018, a flooding event affected areas of Kinshasa that are currently reporting cholera cases. (WHO, 26 Jan 2018)
In week 25 of 2018, 288 suspected cases with 7 deaths (CFR-2.4%) were notified across the country compared to 557 suspected cases with 9 deaths (CFR-1.6%) reported in the previous week 24. During week 25, the provinces of Haut Katanga, Sankuru, Tanganyika, Maniema and Haut Lomani notified 76.4% of all suspected cases. A total of 14,286 cases with 155 deaths (CFR-1.1%) has been reported from week 1 to 25, 2018. (WHO, 6 Jul 2018)
In week 38 (week ending 23 September 2018), 724 cases with 18 deaths (CFR 2.5%) were reported from 12 out of 26 provinces. Six out of the total provinces that reported cases (Kasai Oriental, Tang anyika, Katanga, Kasai, Kongo Central, and Sankuru) reported 92% of the total cases. Since the beginning of 2018 to the week 38, a total of 21 112 cases were reported including 691 deaths (CFR 3.3%).There has been a trend of increasing cases since week 21. A similar trend was observed in the same period in 2017. (WHO, 5 Oct 2018)
The cholera outbreak in the Democratic Republic of the Congo has been increasing gradually in the last three weeks, following a strong decrease in cases observed nationally between weeks 35 and 41. In 2018, the incidence of cholera cases peaked in week 35 (week ending 2 September 2018) with 883 cases. Thereafter, the weekly caseload steadily decreased until week 41 (week ending 14 October 2018) when 559 cases were reported. This downward trend was mostly due to marked improvement of the cholera outbreak situation in the Kasai region. The weekly incidence then started increasing in week 42, with 706 suspected cases reported. In week 44 (week ending 4 November 2018), 828 suspected cases and 20 deaths (case fatality ratio (CFR) 2.4%) were reported, compared to 784 cases reported in week 43. The current trend is driven primarily by an escalation of the cholera outbreak in Tanganyika, Haut Katanga, Sankuru and Kasai-Oriental provinces.
As of 4 November 2018, a total of 25 378 suspected cholera cases and 860 deaths (CFR 3.4%) were reported nation-wide, since the beginning of the year. Twenty out of 26 provinces in the country have been affected, the majority being Kasai-Oriental (5 538 cases, 22%), South Kivu (3 920, 15%), Tanganyika (3 465, 14%), North Kivu (2 591, 10%) and Kongo Central (1 456, 6%).
The greatest number of fatalities has been documented in the following provinces: Sankuru (114 deaths, CFR 8.7%), Upper Katanga (25 deaths, 6.7%), Equateur (47 deaths, 6.2%), Kasai (71 deaths, 5.4%), Lomani (32 deaths, 5.1%), Kasai Oriental (274 deaths, 4.9%), and Kongo Central (48 deaths, 3.3%). (WHO, 16 Nov 2018)
A total of 394 suspected cases of cholera including six deaths (CFR 1.5%) were reported during week 50. The number of suspected cases reported per week has dropped below 500 since the week 48 of 2018. Cases reported in the endemic provinces (South Kivu, Tanganyika, Haut Lomami and Haut Katanga) account for 74% of cases and 33% of deaths in week 50. (WHO, 18 Jan 2019)
In January 2019, a cholera epidemic was declared in Haut Katanga province by the Ministry of Health. During the reporting period, a total of 1,833 cases were registered in the three provinces (944 cases and 26 deaths in Haut Katanga, 757 cases and 23 deaths in Haut Lomani, and 132 cases and 0 deaths in Lualaba). With a total of 49 deceased individuals in January, the average cholera fatality rate in the three provinces is at 2.7 per cent. Considering the total number of 2,306 cases and 68 deaths (fatality rate 2.9 per cent) since January 2018 in Haut Katanga, the 944 cases and 26 deaths in January 2019 represent a significant increase of cholera in this area. (UNICEF, 31 Jan 2019)
During week 36 (week ending 8 September 2019), a total of 783 suspected cases of cholera and 20 deaths were notified from 52 health zones in 11 provinces.
Between week 1 and week 36 of 2019, a total of 18 985 cases including 345 deaths (CFR 1.8%) have been notified from 20 out of 26 provinces. Compared to the same period in 2018 (week 1-36), there is a 6.7% and a 52% decrease in the number of cases and deaths, respectively. (WHO, 29 Sep 2019)
Measles: Over 43 000 cases were reported in 2017. In weeks 1 and 2 of 2018, 713 cases and 13 deaths were reported, with a stable weekly number of cases since week 52 of 2017.The trend of the outbreak has decreased this week. Most of the suspected cases this week were reported from South Kivu province. (WHO, 26 Jan 2018)
From 2018 week 1 to week 35 (week ending 2 September 2018), 23 979 cases (of measles) with 273 deaths (CFR 1.1%) have been reported. During week 35, a total of 962 new cases were reported with nineteen deaths (CFR 1.98%). Epidemic zones are mainly focused in the eastern part of the country. (WHO, 5 Oct 2018)
During week 45 (ending 11 November 2018), 2 551 suspected cases including 33 deaths (CFR 1.3%) were reported across the country. Nighty four percent (94%) of all cases were reported from nine provinces: Tshopo, Haut Katanga, Haut Lomami, Lualaba, South Kivu, Maniema, Ituri, Tanganyika and Kasai Oriental. Since week 23, there has been an increasing trend in the weekly number of cases since week 22. (WHO, 14 Dec 2018)
During week 49 (week ending 9 December 2018), 2 162 suspected cases including 36 deaths (CFR: 1.7%) were reported across the country. Eight provinces including Upper Katanga, Lualaba, Tshopo, Kasai Oriental, Tanganyika, Ituri, Lomami and South Kivu notified 84% of cases. Since week 47, there has been a decreasing trend in the weekly number of reported cases. (WHO, 18 Jan 2019)
In week 36 (week ending 8 September 2019), 5 387 measles cases including 134 deaths were reported from all 26 provinces of the country. In total, 192 (37%) of the 519 health zones across the country have reported a confirmed measles outbreak. Since the beginning of 2019, 183 837 measles cases including 3 667 deaths (CFR 2.0%) have been recorded. Overall, 51% of cases reported in 2019 have been notified from Tshopo, Lualaba, Kasai and Haut-Lomami provinces. (WHO, 29 Sep 2019)
- Plan Stratégique Multisectoriel d’Elimination du Choléra en République Démocratique du Congo 2013 -2017 (29 Feb 2013)
Six hundred ninety-eight cases with 35 deaths (CFR: 5.0%) were reported in week 33 from 13 out of 26 provinces, an increase in cases compare to the previous week when 537 cases were reported. Five provinces (K. Oriental, South Kivu, Sankuru, Tanganyika and Kasai), reported 90.0% of the total cases in week 33. From week 1 to 33 of 2018, a total of 17 069 cases of cholera including 566 deaths (CFR 3.3 %) were reported. From week 1 of 2017, until week 22 of 2018, majority of cases were reported from endemic provinces; since week 23 of 2018 majority of the cases are reported from epidemic provinces. (WHO, 31 Aug 2018)
Health authorities in the southern Haut-Katanga province recorded 855 measles cases and 13 deaths since the start of October. Nearly 80 per cent of those infected are children younger than five years. Vaccination is underway in the mostaffected Kilwa and Pweto health zones. (OCHA, 22 Oct 2018)
Regarding the measles outbreak, a total of 6,839 suspect cases and 71 deaths were reported in the provinces of Haut Lomami (3,416 cases and 47 deaths), Lualaba (3,237 cases and 24 deaths), and Haut Katanga (186 cases and 0 death). The outbreak in Lualaba requires particular attention since this province has not experienced any epidemic for ten years. The health zones of Kasaji (1,377 cases and 6 deaths) and Dilolo (1,110 cases) of Lualaba province have been particularly affected. (UNICEF, 31 Jan 2019)
Most read reports
- WHO: WHO AFRO Outbreaks and Other Emergencies, Week 42: 14 - 20 October 2019 Data as reported by: 17:00; 20 October 2019. 21 Oct 2019
- MSF: Ebola outbreak threatens fragile local health system in eastern Democratic Republic of Congo. 15 Oct 2019
- UNICEF: As measles deaths in the Democratic Republic of the Congo top 4,000, UNICEF rushes medical kits to health centers and vaccinates thousands more children. 9 Oct 2019
- OCHA: Greater Horn of Africa Region: Humanitarian Snapshot (October 2019). 16 Oct 2019
- OCHA: West and Central Africa: Weekly Regional Humanitarian Snapshot (23 September – 7 October 2019). 8 Oct 2019
This Weekly Bulletin focuses on public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 72 events in the region. This week’s main articles cover key new and ongoing events, including:
Ce rapport a été produit par OCHA Bukavu en collaboration avec les partenaires humanitaires. Il est publié par OCHA et couvre la période du 16 septembre au 6 octobre 2019.
• Déclaration officielle de l’épidémie de choléra dans la Zone de Santé de Kindu (Maniema)
• Tensions persistantes dans la région des Hauts Plateaux de Fizi/Itombwe occasionnant de nouveaux déplacés
APERÇU DE LA SITUATION
Situation attendue pour la période courante de Juillet à Décembre 2019 :
La Représentante spéciale du Secrétaire général des Nations Unies, le leadership et tous les personnels de la MONUSCO présentent leurs sincères condoléances aux familles des victimes du tragique accident d’avion survenu jeudi dernier dans la province du Sankuru ainsi qu’à l’ensemble du peuple congolais.
CONSEIL DE SÉCURITÉ
15 OCTOBRE 2019
On trouvera ci-après le texte de la déclaration à la presse faite, aujourd’hui, par le Président du Conseil de sécurité pour le mois d’octobre, M. Jerry Matthews Matjila (Afrique du Sud):
These hands are our most important tools of work but can also be a source of disease and death,” the Nyiragongo Health Zone director, Dr Dan Kapuku, tells the Kiziba community members who have gathered to learn better handwashing practices in the era of Ebola and other infectious diseases.
In Mabalako, a rural health zone in North Kivu province, Democratic Republic of Congo (DRC), the ongoing Ebola epidemic has taken a heavy toll on the fragile health system. Many doctors and health workers have been hired away by the internationally funded Ebola response, leaving health centers and the regional hospital short of staff and financial support, with potentially deadly consequences.
14 OCTOBER 2019
The following Security Council press statement was issued today by Council President Jerry Matthews Matjila (South Africa):
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 70 events in the region. This week’s edition covers key new and ongoing events, including:
Humanitarian crisis in Burkina Faso
Ebola virus disease in Democratic Republic of the Congo
Cholera in Democratic Republic of the Congo.
Operational context and protection situation
DR Congo: The situation is still worrisome with all southern and eastern provinces being affected. A workshop to review PMSEC (on W39) highlighted the need for strengthening community-based approaches, biological surveillance and timely response. Nigeria: The cholera epidemic remains active in the states of Adamawa (21) and Borno (11), which continue to register new cases. Cameroon: New cases of cholera have been reported in the northern and extreme northern regions bordering Nigeria (Borno and Adamawa) and Chad (Mayo Kebbi East)
Hypolite Mandala and his wife, Nadège, were among the first parents to arrive for the measles vaccination at Nzombi Health Centre in Masi Manimba, a village 400 km south of Kinshasa.
They brought their 3-year-old triplet girls. The children had missed out on being vaccinated for measles at the designated age of 6 months and are in serious danger of infection.
The triplets, dressed in black-spotted dresses, patiently sat on a bench, each taking their turn for the vaccine as their parents held them.
KINSHASA/DAKAR/GENEVA/NEW YORK, 9 October 2019 - UNICEF is vaccinating thousands more children against measles and rushing life-saving medicines to health centers across the Democratic Republic of the Congo (DRC), as deaths from the world’s largest measles outbreak top 4,000.
• 43,740 children (116% coverage) aged 6-59 months were vaccinated against measles in Kasai Oriental province during the month of August.
• UNICEF’s Rapid Response to Movements of Population (RRMP) mechanism will be discontinued as of 30th September 2019. A new model, UNICEF Rapid Response will provide a first response, 0ne-off assistance to all population affected by humanitarian crisis
Associate Professor of Biology, Pennsylvania State University
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 71 events in the region. This week’s edition covers key new and ongoing events, including:
Ce rapport a été produit par OCHA Kalemie et Lubumbashi en collaboration avec les partenaires humanitaires. Il est publié par OCHA et couvre la période du 30 septembre au 03 octobre 2019.
• Démarrage du processus de retour volontaire
• Persistance du choléra et de la rougeole, dans certaines zones du Haut-Lomami et du Tanganyika
Since 18 August, thousands of Congolese refugees left Angola to come back to DRC. A Tripartite Agreement was subsequently signed on 23-24 August between UNHCR and the Angola and DRC Governments, to start an organized Voluntary Repatriations movement.
In Kasenyi, Ituri Province, UNHCR and partner CARITAS continued the construction of collective hangars to respond to the arrival of some 4,300 IDPs. So far, 21 hangars are occupied by 252 households. In addition, 333 individual shelters were finalized.
This document provides a mid-month update on major developments between the publication of UNHCR’s monthly Operational Update.